AI Article Synopsis
- IgG4-related pachymeningitis is a severe inflammatory condition causing symptoms like mass effect and focal neurological deficits.
- The typical treatment starts with steroids, but in this case, steroids were not an option, and methotrexate did not work.
- After administering rituximab and anticonvulsants, the patient showed significant symptom improvement, indicating that early rituximab treatment may be beneficial for these patients.
Article Abstract
IgG4-related pachymeningitis is a serious inflammatory condition that can present with symptoms of mass effect and focal deficits. The first-line therapy is steroids and second-line is chemotherapy (methotrexate, azathioprine, etc.). We describe a patient with IgG4-related pachymeningitis in whom steroid use was contraindicated and methotrexate was ineffective. During the course of treatment, the patient presented to the emergency department with receptive and expressive aphasia, slurred speech, right-sided neglect, and loss of sensation. After a single infusion of rituximab and anticonvulsants, her symptoms resolved. Our unique case suggests that patients with IgG4-related pachymeningitis might benefit from early initiation of rituximab.
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| http://dx.doi.org/10.1016/j.jneuroim.2016.08.009 | DOI Listing |
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